5/30/2017 Introductions Suicide Prevention & Daniel Schwarz, Ph.D. The Art of Asking: Bridging Clinical Assessment and Community Conversations to Promote Awareness and Prevention Daniel Schwarz, Ph.D. Anna Trout, MSW Montgomery County Suicide Prevention Task Force Introductions My Step ‐ Brother Boaz • Anna Trout, MSW, CPRP – Prevention Specialist, Montgomery County Office of Mental Health – Coordinator of the Montgomery County Suicide Prevention Taskforce Objectives Scope and Prevalence: • Points of discussion critical to this training: Reported Suicide Deaths in 2015 – The scope and pervasiveness of suicide – Suicide as a preventable Public Health Crisis – The role of psychologists as liaisons to the community ‐ at ‐ large in spreading World wide: more than 800,000 information about suicide awareness and prevention (more than all the wars and homicides combined) • Participants will learn: – Use of the Columbia Suicide Severity Rating Scale (CSSR ‐ S) as an effective Assessment Strategy for Suicide Risk along with some options for the United States: 44,193 (Rate: 13.8) treatment of Suicidal Patients, Attempt Survivors and Family Members – Tenants of QPR Prevention training as both a component of clinical training and practice, as well as a tool for communicating with individuals, families, Pennsylvania: 1,894 (Rate: 14.8) and the community – Strategies for bridging clinical expertise with community engagement to promote awareness, intervention, and connections *Drapeau, C.W., & McIntoch, J.,L. (for the American Association of Suicidology). (2016). U.S.S. suicide 2015: Official Final Data. Washingotn, DC: American Association of Suicidology, dated December 23, 2016, downloaded form http://www.suiciodology.org 1
5/30/2017 Scope and Prevalence: Scope and Prevalence: U.S.A. Data Specifics ‐ Fatal Outcomes U.S.A. Data Specifics ‐ Fatal Outcomes The United States has slowly but steadily seen an increase in suicide rates since 2001, following long ‐ term trends of decline from 1977 ‐ 1986. This trend upward becomes more pronounced from 2007 onward. Suicide is the 10 th ranking cause of death in the U.S. across all ages (note: • homicide ranks 16 th ) 2 nd leading cause of death for 15 ‐ 24 year olds • Means Matter • Firearms (22,018, 49.8% of total deaths) – Suffocation/Hanging (11,855, 26.8% of total deaths) – Poisoning (6,816, 15.4% of total deaths) – Training recommendation: Counseling on Access to Lethal Means (CALM) Scope and Prevalence: Scope and Prevalence: U.S.A. Data Specifics ‐ Who is most at risk? U.S.A. Data Specifics ‐ Who is most at risk? Middle aged folks, particularly white men , are most at risk for death by suicide. In 2015, middle age people were 26.2% of the population , but were 37.3% of • the suicides Men are 3.3 times as likely to die by suicide than women • White men made up 30,658 of the 44,193 suicides (rate of 24.6, with the next • highest rate being Native Americans at 12.6) Scope and Prevalence: Scope and Prevalence: Pennsylvania Montgomery County Pennsylvania Pennsylvania falls slightly above the national average for overall suicide rate. A local partnership : Montgomery County Suicide Prevention Taskforce, Department of Health & Human Services, and PA rate in 2015 was 14.8 (Northeast Region Rate: 10.8, National Rate: 13.8) • Coroner’s Office. Men died by a rate of 23.4 (National Rate: 21.5) • Benefits of local data • Faster turnaround of information (vs waiting for national data to filter up and then back down) – Building relationships and communication between systems – Women died by a rate of 6.5 (National Rate 6.3) • Montgomery County loses approx. 100 people a year to suicide. • PA rates for elderly (15.4) and youth (12.2) suicides are slightly below the • Trends match closely with what’s happening on a national level national rates… middle age deaths are the primary drivers of the suicide rate ( men die 3x more often , middle age deaths are increasing, women in Pennsylvania are most likely to die from an overdose , March is the most common time of year, firearms are most common method at 36% ). 2
5/30/2017 Scope and Prevalence: With the scope of the problem defined…. Montgomery County Pennsylvania (Youth) How can Psychologists be champions of 66% of all youth suicides in Montgomery County happen in September, October, or January…. What do you notice? suicide prevention in Pennsylvania? 65% of public school districts in MontCo have experienced a suicide in the last 7 years *Clinical Practice & Intervention* Most common method for young people is hanging *Community Awareness & Empowerment* Three (3) out of every ten (10) high school students report feeling depressed or sad most days of the year. Clinical Practice & Intervention: Examples of Tools for Assessment • PHQ ‐ 2 • PHQ ‐ 9 • National Prevention Lifeline Suicide Risk Assessment Standards • Colombia Suicide Rating Scale (C ‐ SSRS) 3
5/30/2017 Columbia Suicide Severity Rating Scale (C ‐ SSRS) • A giant THANK YOU to Dr. Kelly Posner, Columbia University, and The Lighthouse Project for their generosity, time, and commitment to making this information free, accessible, and practical for use far and wide, all for the purpose of preventing suicide. • Additional, full, and free toolkits, guides, PDFs, FAQ, videos, and more can be found at: cssrs.columbia.edu Columbia Suicide Severity Rating Scale (C ‐ SSRS) Columbia Suicide Severity Rating Scale (C ‐ SSRS) • Developed in response to a need for Common Language • Suicide Prevention as a mentality • C ‐ SSRS training indicated universally (screening and full version) • Strong research base indicating tool appropriateness and effectiveness Columbia Suicide Severity Rating Scale (C ‐ SSRS) Screening Version Who can use it? 4
5/30/2017 Columbia Suicide Severity Rating Scale (C ‐ SSRS) C ‐ SSRS: Full Version Screening Who should use it? Version Focus: Intensity of Ideation & Suicidal Behavior C ‐ SSRS: C ‐ SSRS: Full Full Version Version (Page 1 of 2) (Page 2 of 2) C ‐ SSRS: Demonstration Administration of C ‐ SSRS: Suicidal Ideation (Screener Demo Video with Police Officer) • Question 1: Have you wished you were dead or wished you could go to sleep and not wake up? • Question 2: Have you actually had any thoughts of killing yourself? • If answer is “ NO ” to Question 2: Move on to Suicidal Behaviors • If answer is “ YES ” to Question 2: Ask Questions 3, 4, & 5 5
5/30/2017 Administration of C ‐ SSRS: Increasing Suicidal Ideation Administration of C ‐ SSRS: Increasing Suicidal Ideation • Question 3: Have you been thinking about • Question 5: Have you started to how you might do this? work out or worked out the details of how to kill yourself? Do you • Question 4: Have you had these thoughts intend to carry out this plan? and had some intention of acting on them? Administration of C ‐ SSRS: Administration of C ‐ SSRS: Intensity of Ideation (Full Version Only) Intensity of Ideation (Full Version Only) • Frequency: How many times have you had these • Duration: When you have the thoughts, how thoughts? long do they last? 1. Less than once a week 1. Fleeting 2. Once a week 2. Less than 1 hour/some of the time 3. 2-5 times in a week 3. 1-4 hours/a lot of the time 4. Daily or almost daily 4. 4-8 hours/most of the day 5. Many times each day 5. More than 8 hours/persistent or continuous Administration of C ‐ SSRS: Administration of C ‐ SSRS: Intensity of Ideation (Full Version Only) Intensity of Ideation (Full Version Only) • Deterrents: Are there things- anyone or anything (e.g. • Controllability : Could/Can you stop thinking family, religion, pain of death)- that stopped you from about killing yourself or wanting to die if you wanting to die or act on thoughts of suicide? want to? 1. Deterrents definitely stopped you from attempting 1. Easily able to control thoughts suicide 2. Can control thoughts with little difficulty 2. Deterrents probably stopped you 3. Can control thoughts with some difficulty 3. Uncertain that deterrents stopped you 4. Can control thoughts with a lot of difficulty 4. Deterrents most likely did not stop you 5. Unable to control thoughts 5. Deterrents definitely did not stop you 6. Does not attempt to control thoughts 0. Does not apply 6
Recommend
More recommend
